From: Subject: CDC Monkeypox | Updated Interim Case Definition for Human Case of Monkeypox Date: Thu, 19 Jun 2003 07:32:42 +0300 MIME-Version: 1.0 Content-Type: multipart/related; boundary="----=_NextPart_000_0000_01C33634.F807B5C0"; type="text/html" X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2800.1106 This is a multi-part message in MIME format. ------=_NextPart_000_0000_01C33634.F807B5C0 Content-Type: text/html; charset="Windows-1252" Content-Transfer-Encoding: quoted-printable Content-Location: http://www.cdc.gov/ncidod/monkeypox/casedefinition.htm CDC Monkeypox | Updated Interim Case = Definition for Human Case of Monkeypox
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Monkeypox=20 Home >
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Updated Interim Case Definition for Human = Case of=20 Monkeypox
June 17, 2003, 9:00 AM ET
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Dow= nload=20 PDF version formatted for print (196=20 KB/3 pages)

The previous=20 case definition (published June 11, 2003) has been updated as=20 follows:

  • Clinical=20 criteria have been revised=20
  • Exclusion=20 criteria have been added=20
  • Suspect,=20 probable, and confirmed case classifications have been revised=20

Clinical Criteria
Rash (macular, = papular,=20 vesicular, or pustular; generalized or localized; discrete or=20 confluent)

Fever=20 (subjective or measured temperature > 99.3=B0 F = (> 37.4=B0=20 C)

Other signs=20 and symptoms

  • Chills=20 and/or sweats=20
  • Headache=20
  • Backache=20
  • Lymphadenopathy
  • Sore=20 throat
  • Cough=20
  • Shortness=20 of breath

Epidemiological Criteria

  • Exposure1<= /SUP>=20 to an exotic or wild mammalian pet2<= /SUP>=20 obtained on or after April 15, 2003, with clinical signs of = illness=20 (e.g., conjunctivitis, respiratory symptoms, and/or rash) =
  • Exposure1<= /SUP>=20 to an exotic or wild mammalian pet2<= /SUP>=20 with or without clinical signs of illness that has been in = contact with=20 a case of monkeypox either in a mammalian pet3<= /SUP>=20 or a human
  • Exposure4<= /SUP>=20 to a suspect, probable, or confirmed human case =

Laboratory Criteria

  • Isolation=20 of monkeypox virus in culture
  • Demonstration of monkeypox virus DNA by polymerase = chain reaction=20 testing in a clinical specimen
  • Demonstration of virus morphologically consistent with = an=20 orthopoxvirus by electron microscopy in the absence of exposure = to=20 another orthopoxvirus
  • Demonstration of presence of orthopox virus in tissue = using=20 immunohistochemical testing methods in the absence of exposure = to=20 another orthopoxvirus.

Case=20 Classification

Suspect Case=20

  • Meets one=20 of the epidemiologic criteria
    AND    =20
  • Fever or=20 unexplained rash AND two or more other signs or symptoms with = onset of=20 first sign or symptom <21 days after last exposure = meeting=20 epidemiologic criteria

Probable=20 Case

  • Meets one=20 of the epidemiologic criteria
    AND    =20
  • Fever AND=20 vesicular-pustular rash with onset of first sign or symptom=20 <21 days after last exposure meeting epidemiologic = criteria=20

Confirmed=20 Case

  • Meets one=20 of the laboratory criteria

Exclusion Criteria
A case may be = excluded as a=20 suspect or probable monkeypox case if:

  • An=20 alternative diagnosis can fully explain the illness5<= /SUP>=20 OR=20
  • The case=20 was reported on the basis of contact with an ill exotic = mammalian pet=20 that was subsequently excluded as a case of monkeypox (e.g., = another=20 etiology fully explains the illness) provided other possible=20 epidemiologic exposure criteria are not present OR=20
  • The case=20 was reported on the basis of contact with an exotic mammalian = pet with=20 or without signs of illness that had been in contact with an ill = animal=20 or human case that was subsequently excluded as a case of = monkeypox=20 (e.g., another etiology fully explains the illness) provided = other=20 possible epidemiologic exposure criteria are not present = OR=20
  • The case=20 was reported on the basis of contact with a human case that was=20 subsequently excluded as a case of monkeypox (e.g., another = etiology=20 fully explains the illness) provided other possible = epidemiologic=20 exposure criteria are not present OR=20
  • A suspect=20 case without a rash does not develop a rash within 6 days of = initial=20 identification or examination of the case

_______________

1 Exposure includes living in a household, petting = or=20 handling, or visiting a pet holding facility (e.g., pet = store,=20 veterinary clinic, pet distributor)
2 Exotic or wild mammalian pets include prairie = dogs, Gambian=20 giant rats, and rope squirrels. Exposure to other exotic or=20 non-exotic mammalian pets will be considered on a = case-by-case=20 basis; assessment should include the likelihood of contact = with a=20 mammal with monkeypox and the compatibility of clinical = illness with=20 monkeypox
3 Contact between mammalian pets includes living in = a=20 household, or originating from the same pet holding facility = as=20 another animal with monkeypox
4 Exposure includes skin-to-skin or face-to-face = contact
5 Factors that may be considered in assigning = alternate=20 diagnoses include the strength of the epidemiologic exposure = criteria for monkeypox, the specificity of the diagnostic = test, and=20 the compatibility of the clinical presentation and course of = illness=20 for the alternative diagnosis
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